Fluoroquinolones (FQs) are widely used drugs around the world. This is a result of their broad spectrum of antibacterial activity, high bioavailability, and known efficacy. Since they appeared on the market, their prescribing frequency has gradually increased. In 2011, FQs became the third most prescribed class of antibiotics in the US. Widespread use of these drugs resulted in an increasing number of reported side effects. In 2016, the FDA warned about significant side effects, including mental disorders in the form of anxiety, psychotic symptoms, insomnia, and depression. Psychiatric adverse reactions to FQs occur with a frequency of 1 to 4.4% and the mechanism of their formation is not entirely clear. It is believed that the antagonistic effect of FQs on the GABA receptor or interaction with the main receptor for the glutamatergic system—NMDA—is responsible for this. The paper is a structured review of 68 selected publications and the latest summary of CNS adverse effects that occur during FQ use. Prescribers should be aware of the risk factors for FQ toxicity, including elderly patients with underlying medical conditions or receiving concomitant medication; however, these adverse events may also occur in other groups of patients.

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. It was once thought to be a disorder affecting only children, but in those undiagnosed in childhood, symptoms do not disappear with age. There is now a growing recognition of the late diagnosis and treatment of adults with ADHD. The first-line drug in pharmacotherapy is methylphenidate, and information about its adverse effects, when used by adults, has not been as extensively described as in children. The aim of this article was to review the literature describing the risks of methylphenidate therapy for adults with ADHD. A total of 19 articles—15 clinical trials and 4 case reports presenting rare side effects resulting from methylphenidate therapy, such as reversible ischemic stroke, myocardial infarction, and psychotic episodes, were analyzed. The analysis from clinical trials included 3458 adult patients with ADHD and described the most common side effects, psychiatric adverse events, effects of methylphenidate treatment on sleep, laboratory results, body mass, and cardiovascular symptoms. Methylphenidate treatment is well tolerated, with side effects described, according to severity, as mild to moderate. We conclude that pharmacotherapy is not risk-free and methylphenidate, due to its side effects, may not be the first drug of choice for every patient.

Introduction and purpose:This review is intended for healthcare professionals, including dermatologists, primary care physicians, and researchers, who seek a comprehensive understanding of vitiligo. It is also relevant for patients and their families to better understand the condition. The review is indicated for those dealing with cases of vitiligo that are difficult to diagnose or manage, those with widespread or refractory vitiligo, and individuals interested in the latest advancements in treatment. The purpose of this review is to provide a detailed analysis of vitiligo’s etiopathogenesis, the current diagnostic methods, and the most effective treatment options. By exploring the genetic, autoimmune, and environmental factors involved in vitiligo, the review aims to enhance the understanding of the disease's origin and progression. Additionally, it seeks to offer evidence-based insights into the most up-to-date diagnostic tools and therapeutic approaches, ultimately improving patient care and guiding future research directions. State of knowledge: Vitiligo is an autoimmune disorder characterized by the loss of melanocytes, leading to depigmented skin patches. Its exact cause remains unclear, but genetic and environmental factors, such as stress and skin trauma, are thought to contribute. Diagnosis is primarily clinical, with dermoscopy and biopsy used in uncertain cases. While treatments like topical corticosteroids, phototherapy, and JAK inhibitors are effective for some, no cure exists, and responses vary widely. Surgical options like melanocyte transplantation can help with localized cases. Ongoing research aims to better understand the disease mechanisms and improve treatment outcomes.

Background: Methylphenidate is a psychostimulant that enhances dopamine and norepinephrine neurotransmission through the mechanism of reuptake inhibition at the synaptic cleft. Studies indicate that sexual dysfunction is prevalent among psychiatric patients. The objective of our study was to assess the impact of methylphenidate on patients’ sexual health, identify specific types of sexual dysfunction, and analyse the correlations between psychiatric disorders, treatment dosages and durations, and the presence of sexual dysfunction. Additionally, we aimed to evaluate the prevalence of improved sexual function resulting from methylphenidate use. Methods: A systematic literature review was performed using the PubMed database in accordance with PRISMA guidelines. The initial search yielded 186 articles, of which 14 met the inclusion criteria and were analyzed. Clinical studies involving changes in libido, erectile function, ejaculation, semen quality, and sexual behavior due to methylphenidate were reviewed. Results: The findings indicate that methylphenidate can have both negative and positive effects on sexual function. In some patients, particularly those with psychiatric comorbidities, methylphenidate was associated with decreased libido and ejaculation disorders. In other cases, especially in individuals with preexisting dysfunctions or on low doses, it appeared to enhance sexual arousal and performance. Conclusions: Methylphenidate may influence sexual function in complex ways depending on individual patient profiles and treatment variables. Clinicians should be aware of these potential outcomes and consider sexual health as part of the therapeutic discussion when prescribing methylphenidate.

Objective: this study aims to comprehensively compare neuropsychological, psychopathological, anthropometric, biochemical, pharmacological, and lifestyle variables between 27 male schizophrenic patients (SZ group) and 30 age- and sex-matched healthy male controls (HC group). Methods: participants underwent a battery of neuropsychological tests including the Trail Making Test (TMT), Stroop Color-Word Interference Test, and Verbal Fluency Test. Psychopathological symptoms in the SZ group were evaluated using the Positive and Negative Syndrome Scale (PANSS). Anthropometric measurements such as body weight, height, BMI, and waist circumference were taken. Biochemical markers measured included fasting glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and fasting insulin. Lifestyle factors were assessed through a questionnaire for the study of views and eating habits of people aged 16 to 65. Results: the HC group outperformed the SZ group in the TMT_A test and the Stroop test, but no significant differences were observed in the TMT_B test or in phonemic fluency tests. No correlation was found between age and PANSS scores within the SZ group. Anthropometrically, the SZ group had higher body weight, waist circumference, and BMI, with no difference in height. Biochemically, the HC group had higher HDL cholesterol levels but lower insulin and insulin resistance indices. Pharmacological assessment showed a more significant impact on body weight among SZ patients taking second-generation antipsychotics. Lifestyle factors such as diet and screen time were comparable between groups, but the SZ group reported longer sleep duration and lower leisure time activity. Conclusions: our study highlights distinct neuropsychological, pharmacological, anthropometric, and biochemical differences between male schizophrenic patients and healthy controls. The results underscore the complexity of schizophrenia and point toward the need for a multi-faceted approach to its management and understanding.

Treatment-resistant schizophrenia (TRS) remains a significant clinical challenge due to limited therapeutic options and a poor understanding of its underlying biology. Recent findings suggest that immune system dysregulation may play a critical role in the pathophysiology of TRS. This systematic review aimed to synthesize current evidence on immunological abnormalities associated with TRS, with a focus on inflammatory markers, immune cell profiles, and the role of autoantibodies, and to explore their potential utility in diagnosis and treatment. A systematic review of the literature was conducted in accordance with PRISMA guidelines, incorporating clinical, molecular, and translational studies on immunological markers in patients with TRS. Included studies assessed cytokine levels, immune cell phenotypes, autoantibodies, genetic factors, and the effects of immunomodulatory therapies. Emphasis was placed on findings differentiating TRS from treatment-responsive schizophrenia. TRS is associated with distinct immune profiles, including elevated IL-6, IL-8, TNF-α, and sCD25 levels, overexpression of CD33 on monocytes and expansion of CD123+ plasmacytoid dendritic cells. Autoantibodies, particularly those targeting glutamatergic receptors, are more prevalent in TRS and decrease with clozapine treatment. Predictive models using IgM autoantibodies and genetic variants show promise for early identification of at-risk individuals. Emerging immunomodulatory treatments such as rituximab, levamisole, and senolytics are under investigation, offering potential for personalized strategies. Immunological dysfunction represents a reproducible and biologically relevant feature of TRS. Integration of immune biomarkers into clinical practice may enhance diagnostic precision and inform personalized therapeutic approaches. Future research should prioritize standardized biomarker protocols and longitudinal studies to validate causal associations and optimize treatment algorithms.